Irritable Bowel Syndrome Clinical Trials

It Is Diagnosed By What Is There, Not By What Is Missing

Many people are told this is what is left when every test comes back clear. However, that is out of date. It is diagnosed positively, using the Rome criteria and the absence of alarm features. So a doctor should be able to name it rather than shrug at it.

Your Type Decides Everything

There are four types, set by what your stool looks like on the days it is abnormal. Constipation type, diarrhoea type, mixed type and undecided. Notably, the drugs work in opposite directions, so the wrong type makes a drug useless. Also, the study on this page takes only the diarrhoea and mixed types.

Three Tests Worth Asking For By Name

Faecal calprotectin rules out inflammatory bowel disease. A tTG-IgA with a total IgA rules out celiac disease, and you must still be eating gluten when it is taken. Finally, a TSH checks your thyroid. So those three are the sensible starting set.

You Probably Do Not Need a Colonoscopy

If you are under 45, have classic symptoms, no alarm features and normal results on those tests, a camera test is usually not needed. Meanwhile, alarm features do change that. Those are bleeding, weight loss, anaemia, symptoms that wake you at night, onset at 50 or over, or a family history.

The Low FODMAP Diet Has Three Phases, Not One

First you cut the trigger foods for two to six weeks. Then you add them back one at a time over six to ten weeks. Finally you settle on a personal version you keep for good. However, most people are handed phase one and never told about phases two and three, which is why it feels like a life sentence.

A Simpler Version Works Nearly as Well

Researchers at Michigan tested a less restrictive version of the same diet. Fewer people dropped out, because it asked less of them. As Shanti Eswaran put it, nobody wants to live like that. So it is worth asking a dietitian about the simplified version rather than the full one.

What the Drugs Actually Do

For the diarrhoea type, options slow things down or calm the gut. For the constipation type, they draw water in or speed things up. Meanwhile, the mixed type has no approved drug of its own at all. In fact, that gap is part of why the study on this page matters.

Camlipixant: Blocking the Pain Signal Itself

This drug blocks a receptor called P2X3, which sits on nerves that carry pain signals. The same family is already used for a stubborn cough, so it is not untested in people. So the question here is whether turning down that signal reduces belly pain. Notably, that is a different target from every approved drug for this condition.

Talking Therapies Are Physical Treatments Here

Gut directed hypnotherapy and gut focused CBT work on the nerve pathway between the brain and the gut. So they are not about being told the pain is in your head. As Laurie Keefer argues, the bar for offering them should be much lower than it is. Also, several are now delivered through apps.

Irritable Bowel Syndrome Help Near You

Start with a gastroenterologist or a dietitian who knows the FODMAP phases. Ask for a faecal calprotectin, a celiac blood test and a TSH. Also, ask which type you are, in writing. Generally, your own doctor can order all three tests.